摘要
目的探讨促红细胞生成素（EPO）对晚期（Ⅲ~Ⅳ期）卵巢癌经紫杉醇化疗后诱发的神经毒性损伤的保护作用。方法选取2009年2月—2012年3月襄阳市中心医院收治的Ⅲ~Ⅳ期卵巢癌患者124例,根据其是否接受EPO治疗及接受治疗的时间分为早期EPO组、晚期EPO组、非EPO组。根据癌症治疗功能评估/妇科肿瘤神经毒性问卷（FACT/GOG-NTX问卷）评分对3组患者行神经毒性评估。比较3组患者神经毒性分级、最早出现神经毒性损伤的时间以及累积紫杉醇用量;比较早期EPO组不同贫血分级患者的神经毒性损伤分级。结果 3组患者神经毒性分级间差异有统计学意义（H=6.862,P=0.032）。早期EPO组不同贫血分级患者的神经毒性损伤分级间差异有统计学意义（u=-3.810,P〈0.05）。早期EPO组发生神经毒性损伤最早时间〔（12.3±2.2）周〕长于晚期EPO组〔（10.7±1.6）周〕及非EPO组〔（7.7±1.2）周,P〈0.05〕。早期EPO组最早发生神经毒性损伤时紫杉醇用量平均为（785.3±67.5）mg,高于晚期EPO组〔（511.6±61.7）mg〕及非EPO组〔（354.2±47.5）mg,P〈0.05〕。结论EPO能够有效减轻以紫杉醇为基础化疗的Ⅲ~Ⅳ期卵巢癌患者神经毒性,早期应用EPO效果更显著。
Objective To explore the role of erythropoietin（ EPO） in neurovirulent damages（ NVD） caused by paclitaxel chemotherapy in patients with advanced ovarian cancers（ AOC）. Methods A total of 124 Ⅲ- Ⅳ stage AOC patients admitted to Center Hospital of Xiangyang from February 2009 to March 2012 were divided,according to receiving EPO treatment or not,into groups early EPO,advanced EPO,non- EPO. FACT /GO- NTX questionnaire was used to evaluate the neurovirulence of 3 groups. The neurovirulence,time of NVD appearance,accumulated paclitaxel were compared among 3 groups. NVDs compared between patients with different grades of anemia in EPO group. Results The incidences of NVD of groups early EPO,advanced EPO,non- EPO were 24. 4%（ 10 /41）,42. 5%（ 17 /40）,53. 5%（ 23 /43）,respectively,the difference was significant（ H = 6. 862,P = 0. 032）. There was difference in incidences of different grades of NVD among 3 groups（ P 0. 05）. There was difference in NVD incidence between patients with different grades of anemia in early EPO group（ u =- 3. 810,P 0. 05）. The earliest time of neurovirulence occurrence was longer in early EPO group 〔（ 12. 3 ± 2. 2） weeks〕than in groups advanced EPO 〔（ 10. 7 ± 1. 6） weeks〕,non- EPO 〔（ 7. 7 ± 1. 2） weeks,P 0. 05〕. The mean paclitaxel dosage was（ 785. 3 ± 67. 5） mg in early EPO group at earliest time of neurovirulence occurrence,higher than in groups advanced EPO 〔（ 511. 6 ± 61. 7） mg〕,non- EPO 〔（ 354. 2 ± 47. 5） mg,P 0. 05〕. Conclusion EPO can reduce the NVD caused by paclitaxel chemotherapy in Ⅲ- Ⅳ AOC patients. Early use of EPO is of more remarkable effects.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第29期3453-3456,共4页
Chinese General Practice
基金
湖北省自然科学基金资助项目(2012FFB01904)
